tbuckley/cabot-search huggingface dataset:
Non-COVID-19 intensive care admissions during the pandemic: a multinational registry-based study
Authors: Joshua McLarty, Edward Litton, Abigail Beane, Diptesh Aryal, Michael Bailey, Stepani Bendel, Gaston Burghi, Steffen Christensen, Christian Fynbo Christiansen, Dave A Dongelmans, Ariel L Fernandez, Aniruddha Ghose, Ros Hall, Rashan Haniffa, Madiha Hashmi, Satoru Hashimoto, Nao Ichihara, Bharath Kumar Tirupakuzhi Vijayaraghavan, Nazir I Lone, Maria del Pilar Arias López, Mohamed Basri Mat Nor, Hiroshi Okamoto, Dilanthi Priyadarshani, Matti Reinikainen, Marcio Soares, David Pilcher, Jorge Salluh
Journal: Thorax (2023)

Background The COVID-19 pandemic resulted in a large number of critical care admissions. While national reports have described the outcomes of patients with COVID-19, there is limited international data of the pandemic impact on non-COVID-19 patients requiring intensive care treatment. Methods We conducted an international, retrospective cohort study using 2019 and 2020 data from 11 national clinical quality registries covering 15 countries. Non-COVID-19 admissions in 2020 were compared with all admissions in 2019, prepandemic. The primary outcome was intensive care unit (ICU) mortality. Secondary outcomes included in-hospital mortality and standardised mortality ratio (SMR). Analyses were stratified by the country income level(s) of each registry. Findings Among 1 642 632 non-COVID-19 admissions, there was an increase in ICU mortality between 2019 (9.3%) and 2020 (10.4%), OR=1.15 (95% CI 1.14 to 1.17, p&lt;0.001). Increased mortality was observed in middle-income countries (OR 1.25 95% CI 1.23 to 1.26), while mortality decreased in high-income countries (OR=0.96 95% CI 0.94 to 0.98). Hospital mortality and SMR trends for each registry were consistent with the observed ICU mortality findings. The burden of COVID-19 was highly variable, with COVID-19 ICU patient-days per bed ranging from 0.4 to 81.6 between registries. This alone did not explain the observed non-COVID-19 mortality changes. Interpretation Increased ICU mortality occurred among non-COVID-19 patients during the pandemic, driven by increased mortality in middle-income countries, while mortality decreased in high-income countries. The causes for this inequity are likely multi-factorial, but healthcare spending, policy pandemic responses, and ICU strain may play significant roles.
Combined hormonal contraceptive use is not protective against musculoskeletal conditions or injuries: a systematic review with data from 5 million females
Authors: Lynita White, Justin M Losciale, Kipling Squier, Sarah Guy, Alex Scott, Jerilynn C Prior, Jackie L Whittaker
Journal: British Journal of Sports Medicine (2023)

Objective Assess the association between combined hormonal contraceptives (CHC) use and musculoskeletal tissue pathophysiology, injuries or conditions. Design Systematic review with semiquantitative analyses and certainty of evidence assessment, guided by the Grading of Recommendations Assessment, Development and Evaluation approach. Data Sources MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to April 2022. Eligibility Intervention and cohort studies that assessed the association between new or ongoing use of CHC and an outcome of musculoskeletal tissue pathophysiology, injury or condition in postpubertal premenopausal females. Results Across 50 included studies, we assessed the effect of CHC use on 30 unique musculoskeletal outcomes (75% bone related). Serious risk of bias was judged present in 82% of studies, with 52% adequately adjusting for confounding. Meta-analyses were not possible due to poor outcome reporting, and heterogeneity in estimate statistics and comparison conditions. Based on semiquantitative synthesis, there is low certainty evidence that CHC use was associated with elevated future fracture risk (risk ratio 1.02–1.20) and total knee arthroplasty (risk ratio 1.00–1.36). There is very low certainty evidence of unclear relationships between CHC use and a wide range of bone turnover and bone health outcomes. Evidence about the effect of CHC use on musculoskeletal tissues beyond bone, and the influence of CHC use in adolescence versus adulthood, is limited. Conclusion Given a paucity of high certainty evidence that CHC use is protective against musculoskeletal pathophysiology, injury or conditions, it is premature and inappropriate to advocate, or prescribe CHC for these purposes. PROSPERO registration number This review was registered on PROSPERO CRD42021224582 on 8 January 2021.
Systematic Development of a Simple Human Gait Index
Authors: Abu Ilius Faisal, Tapas Mondal, M. Jamal Deen
Journal: IEEE Reviews in Biomedical Engineering (2023)

Human gait analysis aims to assess gait mechanics and to identify the deviations from "normal" gait patterns by using meaningful parameters extracted from gait data. As each parameter indicates different gait characteristics, a proper combination of key parameters is required to perform an overall gait assessment. Therefore, in this study, we introduced a simple gait index derived from the most important gait parameters (walking speed, maximum knee flexion angle, stride length, and stance-swing phase ratio) to quantify overall gait quality. We performed a systematic review to select the parameters and analyzed a gait dataset (120 healthy subjects) to develop the index and to determine the healthy range (0.50 - 0.67). To validate the parameter selection and to justify the defined index range, we applied a support vector machine algorithm to classify the dataset based on the selected parameters and achieved a high classification accuracy (∼95%). Also, we explored other published datasets that are in good agreement with the proposed index prediction, reinforcing the reliability and effectiveness of the developed gait index. The gait index can be used as a reference for preliminary assessment of human gait conditions and to quickly identify abnormal gait patterns and possible relation to health issues.
Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among <i>Deepwater Horizon</i> Oil Spill Workers
Authors: Dazhe Chen, Dale P. Sandler, Alexander P. Keil, Gerardo Heiss, Eric A. Whitsel, Jessie K. Edwards, Patricia A. Stewart, Mark R. Stenzel, Caroline P. Groth, Gurumurthy Ramachandran, Sudipto Banerjee, Tran B. Huynh, W. Braxton Jackson, Aaron Blair, Kaitlyn G. Lawrence, Richard K. Kwok, Lawrence S. Engel
Journal: Environmental Health Perspectives (2023)

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Helen Salisbury: Knowing the size of the problem in general practice
Authors: Helen Salisbury
Journal: BMJ (2023)

Helen Salisbury: Knowing the size of the problem in general practice Helen Salisbury GPNo one is doubting that general practice is in trouble-but how much, and how can it be fixed?Repeated interventions have aimed to improve patient access through online booking, e-consultation forms, and new telephones.None of these have created new capacity, and some have contributed to increased demand. 1 One attempt to plug the gap between demand and capacity has been the recruitment of lots of other clinical staff who are not doctors, through the primary care networks' Additional Roles Reimbursement Scheme.
Flow-induced reprogramming of endothelial cells in atherosclerosis
Authors: Ian A. Tamargo, Kyung In Baek, Yerin Kim, Christian Park, Hanjoong Jo
Journal: Nature Reviews Cardiology (2023)

Atherosclerotic diseases such as myocardial infarction, ischaemic stroke and peripheral artery disease continue to be leading causes of death worldwide despite the success of treatments with cholesterol-lowering drugs and drug-eluting stents, raising the need to identify additional therapeutic targets. Interestingly, atherosclerosis preferentially develops in curved and branching arterial regions, where endothelial cells are exposed to disturbed blood flow with characteristic low-magnitude oscillatory shear stress. By contrast, straight arterial regions exposed to stable flow, which is associated with high-magnitude, unidirectional shear stress, are relatively well protected from the disease through shear-dependent, atheroprotective endothelial cell responses. Flow potently regulates structural, functional, transcriptomic, epigenomic and metabolic changes in endothelial cells through mechanosensors and mechanosignal transduction pathways. A study using single-cell RNA sequencing and chromatin accessibility analysis in a mouse model of flow-induced atherosclerosis demonstrated that disturbed flow reprogrammes arterial endothelial cells in situ from healthy phenotypes to diseased ones characterized by endothelial inflammation, endothelial-to-mesenchymal transition, endothelial-to-immune cell-like transition and metabolic changes. In this Review, we discuss this emerging concept of disturbed-flow-induced reprogramming of endothelial cells (FIRE) as a potential pro-atherogenic mechanism. Defining the flow-induced mechanisms through which endothelial cells are reprogrammed to promote atherosclerosis is a crucial area of research that could lead to the identification of novel therapeutic targets to combat the high prevalence of atherosclerotic disease. In this Review, Jo and colleagues discuss blood flow-induced mechanisms involved in endothelial cell dysfunction and atherosclerosis, including the emerging concept of disturbed-flow-induced reprogramming of endothelial cells as a pro-atherogenic mechanism, and highlight the therapeutic potential of targeting of flow-sensitive genes, proteins and pathways.
Optimising prescribing in older adults with multimorbidity and polypharmacy in primary care (OPTICA): cluster randomised clinical trial
Authors: Katharina Tabea Jungo, Anna-Katharina Ansorg, Carmen Floriani, Zsofia Rozsnyai, Nathalie Schwab, Rahel Meier, Fabio Valeri, Odile Stalder, Andreas Limacher, Claudio Schneider, Michael Bagattini, Sven Trelle, Marco Spruit, Matthias Schwenkglenks, Nicolas Rodondi, Sven Streit
Journal: BMJ (2023)

To study the effects of a primary care medication review intervention centred around an electronic clinical decision support system (eCDSS) on appropriateness of medication and the number of prescribing omissions in older adults with multimorbidity and polypharmacy compared with a discussion about medication in line with usual care.Cluster randomised clinical trial.Swiss primary care, between December 2018 and February 2021.Eligible patients were ≥65 years of age with three or more chronic conditions and five or more long term medications.The intervention to optimise pharmacotherapy centred around an eCDSS was conducted by general practitioners, followed by shared decision making between general practitioners and patients, and was compared with a discussion about medication in line with usual care between patients and general practitioners.Primary outcomes were improvement in the Medication Appropriateness Index (MAI) and the Assessment of Underutilisation (AOU) at 12 months. Secondary outcomes included number of medications, falls, fractures, and quality of life.In 43 general practitioner clusters, 323 patients were recruited (median age 77 (interquartile range 73-83) years; 45% (n=146) women). Twenty one general practitioners with 160 patients were assigned to the intervention group and 22 general practitioners with 163 patients to the control group. On average, one recommendation to stop or start a medication was reported to be implemented per patient. At 12 months, the results of the intention-to-treat analysis of the improvement in appropriateness of medication (odds ratio 1.05, 95% confidence interval 0.59 to 1.87) and the number of prescribing omissions (0.90, 0.41 to 1.96) were inconclusive. The same was the case for the per protocol analysis. No clear evidence was found for a difference in safety outcomes at the 12 month follow-up, but fewer safety events were reported in the intervention group than in the control group at six and 12 months.In this randomised trial of general practitioners and older adults, the results were inconclusive as to whether the medication review intervention centred around the use of an eCDSS led to an improvement in appropriateness of medication or a reduction in prescribing omissions at 12 months compared with a discussion about medication in line with usual care. Nevertheless, the intervention could be safely delivered without causing any harm to patients.NCT03724539Clinicaltrials.gov NCT03724539.
Ultraviolet B phototherapy does not increase the risk of skin cancer among patients with atopic dermatitis: A population-based retrospective cohort study
Authors: Mei-Ju Ko, Wan-Chuan Tsai, Ping-Hsiu Tsai, Le-Yin Hsu, Kuo-Liong Chien, Hon-Yen Wu
Journal: Journal of the American Academy of Dermatology (2023)
Dissecting self-supervised learning methods for surgical computer vision
Authors: Sanat Ramesh, Vinkle Srivastav, Deepak Alapatt, Tong Yu, Aditya Murali, Luca Sestini, Chinedu Innocent Nwoye, Idris Hamoud, Saurav Sharma, Antoine Fleurentin, Georgios Exarchakis, Alexandros Karargyris, Nicolas Padoy
Journal: Medical Image Analysis (2023)

The field of surgical computer vision has undergone considerable breakthroughs in recent years with the rising popularity of deep neural network-based methods. However, standard fully-supervised approaches for training such models require vast amounts of annotated data, imposing a prohibitively high cost; especially in the clinical domain. Self-Supervised Learning (SSL) methods, which have begun to gain traction in the general computer vision community, represent a potential solution to these annotation costs, allowing to learn useful representations from only unlabeled data. Still, the effectiveness of SSL methods in more complex and impactful domains, such as medicine and surgery, remains limited and unexplored. In this work, we address this critical need by investigating four state-of-the-art SSL methods (MoCo v2, SimCLR, DINO, SwAV) in the context of surgical computer vision. We present an extensive analysis of the performance of these methods on the Cholec80 dataset for two fundamental and popular tasks in surgical context understanding, phase recognition and tool presence detection. We examine their parameterization, then their behavior with respect to training data quantities in semi-supervised settings. Correct transfer of these methods to surgery, as described and conducted in this work, leads to substantial performance gains over generic uses of SSL – up to 7.4% on phase recognition and 20% on tool presence detection – as well as state-of-the-art semi-supervised phase recognition approaches by up to 14%. Further results obtained on a highly diverse selection of surgical datasets exhibit strong generalization properties. The code is available at https://github.com/CAMMA-public/SelfSupSurg.
Management of women who test positive for high-risk types of human papillomavirus: the HART study
Authors: J Cuzick, A Szarewski, H Cubie, G Hulman, H Kitchener, D Luesley, E McGoogan, U Menon, G Terry, R Edwards, C Brooks, M Desai, C Gie, L Ho, I Jacobs, C Pickles, P Sasieni
Journal: The Lancet (2003)
Function of hepatocyte spheroids in bioactive microcapsules is enhanced by endogenous and exogenous hepatocyte growth factor
Authors: Kihak Gwon, Daheui Choi, José M. de Hoyos-Vega, Harihara Baskaran, Alan M. Gonzalez-Suarez, Seonhwa Lee, Hye Jin Hong, Kianna M. Nguyen, Ether Dharmesh, Go Sugahara, Yuji Ishida, Takeshi Saito, Gulnaz Stybayeva, Alexander Revzin
Journal: Bioactive Materials (2023)

The ability to maintain functional hepatocytes has important implications for bioartificial liver development, cell-based therapies, drug screening, and tissue engineering. Several approaches can be used to restore hepatocyte function in vitro, including coating a culture substrate with extracellular matrix (ECM), encapsulating cells within biomimetic gels (Collagen- or Matrigel-based), or co-cultivation with other cells. This paper describes the use of bioactive heparin-based core-shell microcapsules to form and cultivate hepatocyte spheroids. These microcapsules are comprised of an aqueous core that facilitates hepatocyte aggregation into spheroids and a heparin hydrogel shell that binds and releases growth factors. We demonstrate that bioactive microcapsules retain and release endogenous signals thus enhancing the function of encapsulated hepatocytes. We also demonstrate that hepatic function may be further enhanced by loading exogenous hepatocyte growth factor (HGF) into microcapsules and inhibiting transforming growth factor (TGF)-β1 signaling. Overall, bioactive microcapsules described here represent a promising new strategy for the encapsulation and maintenance of primary hepatocytes and will be beneficial for liver tissue engineering, regenerative medicine, and drug testing applications.
Partial splenic embolization for the treatment of hypersplenism in cirrhosis
Authors: Bruno Sangro, Ignacio Bilbao, Ignacio Herrero, Carmen Corella, Jesus Longo, Oscar Beloqui, Juan Ruiz, Jose M. Zozaya, Jorge Quirog, Jesus Priet
Journal: Hepatology (1993)

Hypersplenism is of great relevance in the management of cirrhosis because of the widespread use of myelodepressant drugs such as interferon or antineoplastic agents. Because no standard therapy exists for this complication, we have evaluated the efficacy and risks of splenic embolization in the treatment of hypersplenism in cirrhosis. Partial splenic embolization was performed in 40 consecutive patients with the following indications: 25 patients with active viral cirrhosis before interferon therapy, 8 patients with unresectable hepatocellular carcinoma before antineoplastic chemotherapy and 7 patients with thrombocytopenia associated with spontaneous bleeding events, with high risk of central nervous system hemorrhage or facing major surgery. After selective catheterization of the splenic artery, partial splenic embolization was performed by means of repeated injections of gelatin sponge until a 40% to 60% reduction in the splenic blood flow was achieved. After partial splenic embolization a significant and sustained increase in platelet and white blood cell count was observed during the follow-up period (mean = 13.9 ± 2.2 mo; range = 1 to 36 mo). The goal of partial splenic embolization was achieved in all but two patients in whom a dose reduction of interferon was needed. Hypersplenism relapsed in only seven patients, and all of them exhibited an embolization of less than 50% of the splenic mass. Postembolization syndrome was the main side effect, but no life-threatening complications were detected. In conclusion, partial splenic embolization is a safe and effective therapy of hypersplenism in cirrhosis. (Hepatology 1993;18:309-314).
Into the microbial niche
Authors: Lucie A. Malard, Antoine Guisan
Journal: Trends in Ecology & Evolution (2023)

The environmental niche concept describes the distribution of a taxon in the environment and can be used to understand community dynamics, biological invasions, and the impact of environmental changes. The uses and applications are still restricted in microbial ecology, largely due to the complexity of microbial systems and associated methodological limitations. The development of shotgun metagenomics and metatranscriptomics opens new ways to investigate the microbial niche by focusing on the metabolic niche within the environmental space. Here, we propose the metabolic niche framework, which, by defining the fundamental and realised metabolic niche of microorganisms, has the potential to not only provide novel insights into habitat preferences and the metabolism associated, but also to inform on metabolic plasticity, niche shifts, and microbial invasions.
Cardio-Renal-Metabolic Overlap, Outcomes, and Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction
Authors: John W. Ostrominski, Jorge Thierer, Brian L. Claggett, Zi Michael Miao, Akshay S. Desai, Pardeep S. Jhund, Mikhail N. Kosiborod, Carolyn S.P. Lam, Silvio E. Inzucchi, Felipe A. Martinez, Rudolf A. de Boer, Adrian F. Hernandez, Sanjiv J. Shah, Magnus Petersson, Anna Maria Langkilde, John J.V. McMurray, Scott D. Solomon, Muthiah Vaduganathan
Journal: JACC Heart Failure (2023)

Cardio-renal-metabolic (CRM) conditions are individually common among patients with heart failure (HF), but the prevalence and influence of overlapping CRM conditions in this population have not been well-studied. This study aims to evaluate the impact of overlapping CRM conditions on clinical outcomes and treatment effects of dapagliflozin in HF. In this post hoc analysis of DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure), we evaluated the prevalence of comorbid CRM conditions (atherosclerotic cardiovascular disease, chronic kidney disease, and type 2 diabetes), their impact on the primary outcome (cardiovascular death or worsening HF), and treatment effects of dapagliflozin by CRM status. Among 6,263 participants, 1,952 (31%), 2,245 (36%), and 1,236 (20%) had 1, 2, and 3 additional CRM conditions, respectively. HF alone was uncommon (13%). Greater CRM multimorbidity was associated with older age, higher body mass index, longer-duration HF, worse health status, and lower left ventricular ejection fraction. Risk of the primary outcome increased with higher CRM overlap, with 3 CRM conditions independently associated with highest risk of primary events (adjusted HR: 2.16 [95% CI: 1.72-2.72]; P < 0.001) compared with HF alone. Relative benefits of dapagliflozin on the primary outcome were consistent irrespective of the type of CRM overlap (Pinteraction = 0.773) and by the number of CRM conditions (Pinteraction = 0.734), with greatest absolute benefits among those with highest CRM multimorbidity. Estimated 2-year numbers needed to treat with dapagliflozin to prevent 1 primary event were approximately 52, 39, 33, and 24 for participants with 0, 1, 2, and 3 additional CRM conditions at baseline, respectively. Adverse events between treatment arms were similar across the CRM spectrum. CRM multimorbidity was common and associated with adverse outcomes among patients with HF and left ventricular ejection fraction >40% in DELIVER. Dapagliflozin was safe and effective across the CRM spectrum, with greater absolute benefits among those with highest CRM overlap (Dapagliflozin Evaluation to Improve the LIVEs of Patients With Preserved Ejection Fraction Heart Failure [DELIVER]; NCT03619213).